Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 35.133967 | OH |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | D74754 | MD |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD181943 | OR |
NPI | 1013236819 |
---|---|
Provider Name | Dr. Dane Jeffery Genther |
First Address | Cleveland, OH 44195 |
Second Address | Cleveland, OH 44195 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2010 |
Last Update Date | 03/07/2019 |